Law on Fit-Notes

Employers and employees need to know about the fit-note legislation that became law on 6th April 2010. Lawyer Steven Eckett explains.

The fit-note (Med3), right, replaces the sickness certificate which previously authorised the employee’s sickness absence for a specific period of time.

The main difference with the introduction of fit-notes is that doctors and medical practitioners have to tick one of two options relating to your health, either that they are:

  • ‘unfit for work’ or
  • ‘may be fit for work taking account of the following advice’.

The GP or medical practitioner will then make suggestions in relation to getting the employee back to work.

The main purpose of introducing the change by the previous Labour Government was to reduce the levels of sickness absence rates, to get employees back to work and to change the culture of long term sickness absence. Therefore instead of only clarifying that the employee is not fit to work for a defined period of time, the new regime actually encourages GP and medical practitioners to clarify if possible whether the employee can return to work following the introduction of any reasonable adjustments at work. Some examples of these might involve introducing alternative lighter duties, reducing hours of work and a phased return to work, or making adjustments to the employee’s work station or working environment.

Fit to return

For many employers, the main source of confusion is whether or not an employee can actually return to work before the end date stated on the fit-note. The answer is that the fit-note represents advice from a GP or medical practitioner and is not binding on the employer. On this basis if the employee agrees with the employer that it is appropriate to return to work and they can support them to do so, then there is no requirement to wait until the end of the period stated to return.

The main aim of the fit-note regime is to promote communication between employers and employees about health issues and to ensure that both sides can take more control over the way sickness absences can affect the organisation, especially where budgets are tight and employers are reluctant to take on temporary cover staff.

Employers may engage the services of occupational health practitioners who can play a crucial support role in bridging the knowledge gap between employers, their HR professionals and management, medical practitioners and the employee themselves relating to fit-notes and any proposed medical advice. They can also be extremely proactive in the communication process relating to whether the employee can return to work before the expiry date of the fit-note.

Although the new fit-note regime is currently in its infancy, it could - if used properly - radically change perceptions about work, ill-health and absence and how medical practitioners, managers and occupational health professionals work together. It could also eradicate the current mindset that employees are either well enough to work or simply unable to work as limited options and instead focus on what the employee actually can do with Occupational Health professionals taking a central role in these negotiations.

On a slightly different note, employers and HR professionals are also warned that there are authentic looking replicas of fit-notes circulating for as little as £10 on the internet which are written on official doctors notepaper and stamped and that they can easily be scammed by these fake documents if they unfamiliar with their format.

Your obligations as an employee

The mechanics of signing off sick have not changed very much and fit-notes, like their predecessors can only be issued by a GP or medical advisor from the seventh day of continuous absence. Any absences of seven days or less are covered by the employee completing a self assessment form on their return to work.    

The onus is also on the employee to ensure that they regularly get their fit-notes updated on a regular basis if they remain unfit to attend work. If not, this could delay payments of any statutory or contractual sick pay from your employer.

It is also a good idea for employees to stay in touch with their employers and to keep them updated on their progress and any medical treatment and improvements to their health. If employers also follow good practice relating to the purpose of the introduction of the fit-note regime then dialogue should in any event take place with employees via their HR departments and occupational health professionals.

It is also important to emphasis to individual employees that the requirements for the payment of statutory sick pay have not changed. On this basis, if the employee’s GP or medical practitioner recommends that an employee ‘may be fit for work’ and the employee and employer agree that the employee should remain off work, then payment of statutory sick pay will still be made providing of course that the employee is eligible to receive such payments.

Hopefully time and good practice will radically alter the way in which sickness absence is treated, focusing on what the employee can undertake at work as opposed to having a closed mind set and accepting that the employee has been signed off on long term sickness absence.


This article reflects the experience of the individual. It is not health information from the MHF under the terms of the NHS England Information Standard. It was last updated in 2011.

Page created on November 22nd, 2010

The Men’s Health Forum need your support

It’s tough for men to ask for help but if you don’t ask when you need it, things generally only get worse. Especially during a major pandemic like Covid-19. So we’re asking.

Men appear more likely to get Covid-19 and far, far more likely to die from it. The Men's Health Forum are working hard pushing for more action on this from government, from health professionals and from all of us. Why are men more affected and what can we do about it? We need the data. We need the research. We need the action. Currently we're the only UK charity doing this - please help us.

Here’s our fund-raising page - please chip in if you can.

Registered with the Fundraising Regulator